Application of Yunnan Baiyao in the perioperative period of prostate vaporization electrosurgery
Prostate enlargement is a common and frequent disease in elderly men. Symptoms generally appear gradually after the age of 50 and have a tendency to progressively worsen, often requiring pharmacological treatment or surgical treatment.
With the aging of the population, the number of patients with prostatic hyperplasia has increased significantly, and with the improvement of the new rural cooperative medical care and urban medical insurance, the majority of patients with prostatic hyperplasia have a much higher rate of consultation and hospitalization. The treatment of prostate hyperplasia has tended to be minimally invasive, with the introduction of advanced equipment such as holmium laser and green laser, and vaporization electrodes are gradually becoming popular in county and town level primary hospitals, but the source of disease in primary hospitals is relatively small, and doctors have varying degrees of surgical proficiency, and patients are seen relatively late, often with severe hyperplasia and repeated urinary retention.
Prevention of intraoperative bleeding is still the key to prevent intraoperative complications, and adequate preoperative preparation and perioperative treatment are the keys to prevent intraoperative bleeding. A clinical study on the prevention of intraoperative hemorrhage by preoperative oral administration of Yunnan Baiyao capsules in 260 patients between 2007.3 and 2009.6 was conducted, and the efficacy is reported as follows.
1. Data and Methods
Clinical data
There were 260 patients with BPH who underwent TURP, aged 52-96 years, with an average age of 76 years. The transabdominal measurement of prostate volume was greater than 40 ml, of which less than 60 ml was moderate and greater than 60 ml was severe. There were 5 cases of concomitant bladder stones, 1 case of concomitant bladder diverticulum tumor and 2 cases of intracavitary bladder tumor. Preoperatively, 1 liver insufficiency and abnormal coagulation function were excluded; 2 renal insufficiency and obvious anemia.
1.2 Treatment method
The treatment group took Yunnan Baiyao capsule 0.5 tid orally three days before surgery, and Yunnan Baiyao insurance sub orally 30 minutes before surgery. The oral administration of Yunnan Baiyao capsule 0.5tid was continued for one day after surgery.
The control group was treated with routine anti-inflammatory therapy before surgery, and vitk1 injection 30mg was applied intravenously for 2-3 days after surgery.
1.3 Observation method
The patients were randomly divided into two groups: the group taking Yunnan Baiyao and the group not taking it. For the two groups of cases with different prostate
The flushing solution used during the operation, the operation time and the postoperative flushing time were compared.
1.4 Statistical methods
The data obtained were expressed as X±s, and the t-test and simple correlation analysis in SPSS10.0 software were used
Statistical processing was performed.
2 Results
Table 1 Comparison of preoperative and postoperative results between treatment and control groups
Group Prostate volume Number of cases Operative time Intraoperative flushing fluid volume Postoperative flushing time
(ml) (min) (ml ) (d)
Treatment group 40-60 78 25-35 5000-6000 1.5-2
60-80 68 30-55 7000-1200 1.5-2
Control group 40-60 66 35-55 5500-8500 1.5-3
60-80 48 50-70 9000-1700 2 C 3
As can be seen from Table 1, the differences in each variable of operative time, intraoperative flushing volume, and postoperative flushing time were right statistically significant (P<0.05) in the treatment group compared to the control group.
3 Discussion
As the standard of living increases, the age of prostate patients is getting older and combined with different degrees of cardiac and pulmonary disorders and other multi-organ diseases. From 2007.3 to 2009.6, 260 patients with prostatic hyperplasia were admitted to our department, with an average age of 73 years and a maximum age of 96 years. There were 88 cases (30%) of patients with chronic bronchitis, obstructive emphysema and various degrees of pulmonary insufficiency. There were 65 patients (25%) with coronary artery disease, arrhythmia and mild cardiac insufficiency, including 6 patients with atrial fibrillation. There were 215 patients with hypertension, accounting for 82.6%. Diabetic patients were 47 cases, accounting for 18%.
Prostate vaporization electrosurgery is considered the gold standard for the treatment of BPH [1]. Since the emergence of vapor electrosurgery in 1994, plasma, holmium laser, and green laser vapor electrosurgery have been introduced one after another. With the localization of vapor electrosurgery, the cost of equipment has been reduced and has been gradually carried out in primary hospitals, but the cost of holmium laser and green laser equipment is too high to be acquired in primary hospitals. The main reason for this is that the prostate gland is larger in size and often has multiple urinary retention, recurrent urinary tract infections, bladder stones or inguinal hernia. Less intraoperative bleeding and shorter surgery time is the key to preventing all intraoperative complications.
Yunnan Baiyao capsule has the function of resolving blood stasis and stopping bleeding, activating blood circulation and relieving pain. It can obviously promote platelet coagulation, enhance the activation percentage of platelets and the expression of platelet surface glycoprotein, shorten the bleeding time, and have obvious constricting effect on arterial blood vessels to reduce intraoperative bleeding. It can also alleviate the microcirculatory disorders caused by high molecular dextran, reduce the viscosity of whole blood, improve the blood flow status, and have an effect on antithrombosis.
Our observation showed that there was a statistically significant difference between the treatment group and the control group in terms of intraoperative flushing fluid volume, operation time, and postoperative flushing time. The drug-taking group was able to significantly shorten the operative time by reducing intraoperative bleeding, making the surgical field clearer, and accelerating the cutting speed. And it was able to reduce the absorption of electrosurgical fluid and avoid the occurrence of electrosurgical syndrome. The clear field of view can well identify the depth of the cut and avoid the occurrence of surgical perforation of the peritoneum and urinary extravasation.
In city and county level basic hospitals prostate enlargement patients have relatively large prostate volume, the clinical surgical experience of doctors varies, the prevention of intraoperative bleeding is the key to prevent all complications and can improve the clinical surgical experience of beginners more quickly. In addition to reducing intraoperative bleeding, Yunnan Baiyao capsule can also prevent the formation of postoperative thrombosis and has obvious safety for elderly patients, which is worth promoting the application.